As much of the world now knows, in 2010 Philip Morris International (PMI) sued the Government of Uruguay for its newest measures to reduce tobacco use.

The government had:

increased the size of health warnings on cigarette packets from 50 percent of the total pack size to 80 percent;

changed the design of six messages that would fill the 80 percent space;

passed a regulation that forced companies to sell only one variation of cigarettes per brand (to get around a previous prohibition on labelling cigarettes as ‘light’ or ‘ultralight’, some manufacturers had taken to colour-labelling cigarette packs).

PMI claimed the measures violated its intellectual property rights guaranteed in a trade treaty between Uruguay and Switzerland, where the company is located. The industry’s challenge was strategic, as FCA’s Regional Director for the Americas, Eduardo Bianco, explained on CBC Radio.

Uruguay 'a pawn'

“Uruguay was just a pawn in this chess game. The real intention of Philip Morris was using Uruguay to scare other Latin American countries and other developing countries so they didn’t follow the example of Uruguay,” Eduardo said on the programme The Current in January 2014.

Other countries in the region have since gone ahead with tobacco control measures, but we don’t know how many plans were delayed or cancelled because of PMI’s move. We do know that the tobacco industry has increased its use of international agreements to contest governments’ tobacco control measures, including plain packaging.

What about Uruguay itself? What is the state of tobacco control there five years after PMI launched its challenge?

There are both positive and negative developments. According to a report by the ITC Project, the percentage of smokers not planning to quit decreased from 40 percent in 2006 to 31 percent in 2012. There was also an increase in the number of smokers who had made a quit attempt in 2012 (44 percent), compared with 2010-2011 (39 percent).

More affordable

However, cigarettes in Uruguay had actually become more affordable between 2006 and 2012, because prices had not kept pace with smokers’ buying power.

The government did implement further measures. In September 2014, it ratified the Protocol to Eliminate Illicit Trade in Tobacco Products, a new international treaty and the first protocol to the WHO Framework Convention on Tobacco Control (FCTC). And it banned the only form of tobacco advertising that was still legal – at sales counters, a ban that came into effect on 31 Dec. 2014

PMI’s challenge continues to work its way through the World Bank International Centre for Settlement of Investment Disputes, where in March, Uruguay submitted its 500-page defence. Also earlier this year the WHO, Pan-American Health Organization and FCTC Secretariat were given permission to submit briefs on the case.

Perhaps the most significant development has been Uruguay’s status as a tobacco control champion, and target of the multi-billion-dollar tobacco industry.

Bloomberg support

Soon after PMI launched its challenge, former New York Mayor Michael Bloomberg announced that he would pay legal fees for the Government of Uruguay’s defence.

Meeting in the country in November 2010, the 172 Parties to the WHO tobacco control treaty adopted the Punta del Este Declaration. It expressed “concern regarding actions taken by the tobacco industry that seek to subvert and undermine government policies on tobacco control”.

The Declaration, named for the Uruguayan city where the meeting was held, stated that FCTC Parties “have the right to define and implement national public health policies pursuant to compliance with conventions and commitments under WHO”.

In 2014, the FCTC Secretariat established a tobacco control knowledge hub in the country. Its mandate is “to promote the sharing of information and knowledge on implementation of the Convention internationally,” said the Secretariat.

Uruguay’s citizens appear to support the country’s tobacco control efforts. In 2012, 68 percent of smokers said they believe the government should take even stronger action to protect the public from the harms of smoking, compared with less than half of smokers in 2006, according to the ITC.